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IC Taxes [2008-07-28]
Make sure you either get with a good accountant or get a really good tax program (we use TurboTax every year) because as an IC, taxes don't get taken out of your check, but you get to take deductions for everything that you use for your business. If you own your house, you can deduct the square footage of your office space from your mortgage, you can deduct part of your electricity bill, cell phone, internet, any equipment you have to buy, milage if you have to travel for work - the list can go on and on. Just make sure to keep receipts and good records - I got audited my first year as an IC. I passed with flying colors because everything was legit and I had a receipt to back it up. Hope this helps you and good luck!!! =)
you are an IC if the company you work for does not pay your taxes.... [2007-12-30]
When you are an IC, you tell the company who contracts with you how much work you can provide. It is no different than any other contractor who tells you they will do something for so much money. If they do not perform what is promised, you will probably not rehire them. Same thing goes for IC's. You can be let go for not keeping your end of the bargain.
There are great tax benefits for being an IC, but I strongly recommend you seek the assistance of a professional CPA for this come tax time.
Wait a second....speaking of taxes. [2006-03-31]
As long as NAFTA is in effect, don't these foreign companies MTing for the US (and also the foreign MTs) get away with paying NO taxes? I saw we all stop paying. This country is one big mess.
I'll quit paying taxes if they use it to train overseas MTs [2006-03-21]
G et AL can take a bite out of that one if they think that is the direction they will take this program! After all, the approved programs are online and AAMT provides certification overseas, so what is to stop the big MT corporations who are devoloping facilities to house 5000 MTs in India and other locations from using MY tax money to train overseas MTs???
Foreign speaking docs [2005-12-01]
They keep the FSDs HERE for us to struggle with and send the easier stuff to India where the MTs who don't speak English are given an 8 week crash course in English diction, typing and computer processing. Those of us who have worked our entire adult lives in this profession are left to keep the FSDs from getting their backends sued for malpractice. I'm proud of my profession and resent being demeaned and cheated out of what I've spent a lifetime perfecting by seeing it given away by a money hungry, two-faced oursourcing country that swears on a stack of Bibles that we do not now and never will outsource outside the United States. Way to go Spheris.
IC Taxes [2008-07-28]
Make sure you either get with a good accountant or get a really good tax program (we use TurboTax every year) because as an IC, taxes don't get taken out of your check, but you get to take deductions for everything that you use for your business. If you own your house, you can deduct the square footage of your office space from your mortgage, you can deduct part of your electricity bill, cell phone, internet, any equipment you have to buy, milage if you have to travel for work - the list can go on and on. Just make sure to keep receipts and good records - I got audited my first year as an IC. I passed with flying colors because everything was legit and I had a receipt to back it up. Hope this helps you and good luck!!! =)
Working as an IC sm [2008-07-20]
I likeworking as an IC more than working as a full time employee....I just do not make good employee material due to my health. Although I really, really need health insurance, I just cannot deal with shift work but I will have to at this point and time in my life. I did just accept a job as an employee, tho, because I am getting older and I have to think about taxes, Medicare, etc.....So, I am praying that it will work out.......as I am determined to MAKE it work.
You can make more money as an IC because taxes aren't taken out, BUT........you do have to put aside monies for paying taxes, etc...and with what most MTSOs are paying these days, the cost of living, the awful state of the economy, it is pretty hard to do that.
Also, MOST companies even dictate a schedule to you anyway, even as an IC, which is wrong on so many levels, and I think we as MTs all know this.
Also agree...sm [2008-06-29]
...sit down where it’s quiet, where you can relax and concentrate on your speaking habits.
Pardon me, but, =)) ROFL!
“Mumbling,” says Dr. Block, “that’s the main problem. No kidding!!!
But for voice recognition, doctors need to speak in a normal, conversational tone of voice, Again, =)) ROFL! Yeah, like that's gonna happen!
Won't stop 'em [2008-03-28]
...and do you really think that will make a difference?
I don't think you realize how much money they make by offshoring. The will not beadversely affectedby losingtax breaks - Tax breaksare really only an issuefor the little guy, the guy who needs the break in order to survive, but when you are making that much money, giving a little back to uncle Sam affects your bottom linevery minimally, relatively speaking.
It certainly will not change the practice or stop them from making huge profits.
Yes, but even when the overseas business build plants [2006-04-04]
breaks and incentives that it is the exact same thing, just on our home soil. One state gave Mercedes the land to build 2 plants for free plus no taxes to the state for 10 years, plus other perks picked up by the state residents.
I think I'm going to get religion so I can legally stop paying taxes and ask for my SS account to be refunded (like that would ever happen!)
Wait a second....speaking of taxes. [2006-03-31]
As long as NAFTA is in effect, don't these foreign companies MTing for the US (and also the foreign MTs) get away with paying NO taxes? I saw we all stop paying. This country is one big mess.
Real nice to know [2006-03-29]
that the doctor has so much more respect for a machine than he does the human ears that have to make a living listening and typing the reports day after day! This is what the doctor said...
“Try a few charts each day, and sit down where it’s quiet, where you can relax and concentrate on your speaking habits. Tech support is great; they’ll help you, and be sure to read the help file “How to Speak to a Computer”—and the manual. Especially for often repeated phrases, the voice-actuated “macros” are great, a real time-saver. It’s well-worth the time you invest in learning how to use this tool.”
What are the pitfalls? “Mumbling,” says Dr. Block, “that’s the main problem. Doctors are used to dictating in a low, monotone mumble, as fast as they can. A person might be able to handle it by going back and listening to the recording again and again. But for voice recognition, doctors need to speak in a normal, conversational tone of voice, just like we are doing right now. Speak normally, and Dragon has no problem, it works very well. It’s really quite simple.”
Neurologist saves $12,000 per year on medical transcription [2006-02-22]
Recognition vs. Transcription
W. Palm Beach, FL neurologist saves $12,000 per year on medical transcription using state-of-the-art voice recognition software
[ClickPress, Tue Feb 21 2006] Dr. H. Steven Block, M.D. uses Dragon NaturallySpeaking Medical Edition, voice recognition software for medical professionals, to eliminate a very real business problem--medical transcription costs-- which six years ago, began topping the $1,000-a-month mark. Today, a doctor can easily spend three times that amount.
Very open about his high regard for the Dragon Medical VR product, Dr. Block had much to say about its place in his solo practice: “I purchased Dragon Medical from Eric Fishman’s company, Nuance, which is actually located in the same building as my practice, on the floor above me. Neurology is all about ‘nuance’, no pun intended. But ‘nuance’ is really the best word to describe the health effects of a neurological problem. It has been a major focus of my practice.”
“Very subtle neurological changes can have devastating health consequences. You have to be able to communicate those subtleties in order for a medical record to have any meaning.”
“I see some really sick patients. Using an on-the-spot note generation product like Dragon, instead of a transcription service, let’s me get back to the referring physician with a fast note, usually within 10 minutes of seeing the patient. That kind of speed in delivering a medical exam note with ‘nuance’ can mean a great deal to everyone involved. You see, I can’t type. I never learned how to type. My kids who grew up instant-messaging can type faster than I can speak. They don’t need Dragon. But for me, Dragon is a wonderful tool.”
Dr. Block, 49, is no stranger to high technology tools:
“There are only so many hours in the day,” he laughed, driving down the road, talking via wireless cell phone headset, “and I’m very detail-oriented. I couldn’t be without Dragon, quite frankly.” One word I did not hear from Dr. Block is the word “downtime”. It doesn’t seem to exist in his vocabulary.
Having traveled the long and winding upgrade path for both Dragon and laptop hardware, Dr. Block has watched and participated in the evolution of the product for six years. “Like a surfer looking for the perfect wave,” he joked. The improvement he’s seen in the most recent version of Dragon Medical—combined with a high-RAM laptop with at least 512MB—has boosted performance to an almost unbelievable 99.5% real time voice recognition accuracy level, according to his observations.
His advice to new users: “If you haven’t tried Dragon Medical in the last four years,” he said, “try it again, the way it is now, with the new speech engine. It uses mathematical models to analyze word groups. There is a learning curve, but the training is not that bad, consisting of you reading a 15 minute script into a microphone, then a little touch-up here and there.”
“Try a few charts each day, and sit down where it’s quiet, where you can relax and concentrate on your speaking habits. Tech support is great; they’ll help you, and be sure to read the help file “How to Speak to a Computer”—and the manual. Especially for often repeated phrases, the voice-actuated “macros” are great, a real time-saver. It’s well-worth the time you invest in learning how to use this tool.”
What are the pitfalls? “Mumbling,” says Dr. Block, “that’s the main problem. Doctors are used to dictating in a low, monotone mumble, as fast as they can. A person might be able to handle it by going back and listening to the recording again and again. But for voice recognition, doctors need to speak in a normal, conversational tone of voice, just like we are doing right now. Speak normally, and Dragon has no problem, it works very well. It’s really quite simple.”
He stated that using a handheld Sony digital voice recorder with removable memory stick allows him to dictate anywhere, anytime, then later, “feed” the sound file to Dragon, achieving about 98% voice recognition accuracy. (Please note: If you are considering making a recording for later voice recognition by Dragon, be sure and use 16-bit resolution .avi format, or Dragon won’t even try to “digest” it. It won’t bother with a recording of poor quality, because the end result would be useless.)
Although he is considering it, Dr. Block has not yet adopted a commercial EMR(Electronic Medical Records) software system for his medical records, mainly because of concerns about interoperability standards. (Coming soon to an EMR near you.)
However, by using Dragon Medical as his “front-end” for the creation of detailed paper medical records, email reports, and digital-FAX messages, Dr. Block not only uses computers, but has also created a highly personal and expressive way to “chart” a patient, unmatched in detail, depth, and the “human touch” by out-of-the-box EMR software.
Would EMR software developers do well to discuss with this doctor any design plans for a voice-controlled, voice-recognition-based EMR program? I think so. Will a “hands-free” EMR workstation which responds to voice commands--as does the entire Dragon program--ever be used to help maintain a “sterile field” in the medical environment of the future? It certainly worked well on the Starship Enterprise, didn’t it?
HERE's more of what he thought 10/05...sm [2006-02-21]
TAMT NEWS
Texas Association for Medical Transcription
____________________________________________________________________
A recognized component of AAMT October 2005
SPECIAL MESSAGE FROM PETER PREZIOSI, PhD, CAE
I would challenge this group to think of new and expanded roles for transcriptionists in the electronic health environment. Let’s not think of transcription as it is today but as a role that is at the nexus of health information and information technology.
Transcriptionists should be reattached from the physician dictator and deployed to the entire electronic health record, ensuring that data captured, documentation, and report generation is accurate, complete, and appropriately placed throughout the record. Emerging roles for the Transcriptionist include database administrator, data abstraction, data coding, etc. Once both the profession and the industry embrace this concept, we must quickly put together the educational infrastructure and partner with the technology vendor community to build the software to support this vision, creating an emerging role in the workplace. This new role in the EHR expands the value of transcription, gets transcription away from production and being considered a commodity, and makes us true team players in quality patient documentation. Think of the individuals we could attract to the profession if this were the scope of practice!
This is a long-term vision that requires us to begin now to reposition both the profession and the industry. Let’s not wait for the crisis to worsen.
Peter Preziosi, PhD, CAE
Executive Director
American Association for Medical Transcription
100 Sycamore Avenue
Modesto, CA 95354
(209) 341-2445
(209) 527-9632 fax
peter@aamt.org
www.aamt.org/ca/texas/newsletter.doc
Spheris to Acquire Vianeta Communications [2005-12-21]
Integrating Vianeta's open and scalable XML-based software into Spheris'existing medical transcription technology will also accelerate a host of otherinitiatives Spheris is currently executing and further developing for both itstechnology and service capabilities. Speaking on behalf of the entire Vianeta team, we are pleased to bejoining such an industry force, said Vianeta Chief Executive Officer RalphAceves. We are looking forward to becoming part of the Spheris mission tolead the medical documentation industry through superior services and best-in-class technology. Following completion of the transaction, Spheris will continue to serviceand enhance the Vianeta solutions currently deployed in the marketplace. The transaction, which is subject to customary closing conditions, isexpected to close in the first quarter of 2006. Financial terms of theparties' agreement were not disclosed.
HL7 Launches eHealth Effort for Katrina Relief [2005-09-30]
The Health Level Seven, Inc. (HL7) community is supporting the development of portable, interoperable electronic health records for the hundreds of thousands of people whose lives have been disrupted by Katrina. Many HL7 members are already involved, improving access to vital healthcare information and HL7 has formed a task force to support and guide further efforts. Last week, HL7 issued a call to members to participate and is forging relationships with other industry groups to solve the immediate and long-term problems of disaster relief and preparedness.
The HL7 community represents the most concentrated group of interoperability expertise anywhere. We are rising to the challenge of rebuilding the medical records of the displaced population and doing so in a way that can become a model for the future of the country, says Mark Shafarman, HL7 Chair. We stand ready to work with anyone and everyone implementing standards-based applications. Our Reference Information Model for healthcare, our community of experts and our standards and specifications for interoperability can guide this process. The Healthcare Information and Management Systems Society (HIMSS) Electronic Health Record Vendors' Association (EHRVA) is already working with the Office of the National Coordinator for Health Information Technology (ONCHIT) towards constructing and integrating an electronic health record (EHR) infrastructure within the areas of the gulf coast affected by Hurricane Katrina.
HL7 Standards Making a Difference
HL7 standards are already making an impact on the ground in the wake of Katrina providing access to records of childhood immunization records. The American Immunization Registry Association (AIRA) (www.immregistries.org) -- an HL7 member organization -- reports that nine registries are now using HL7 messages to query the Louisiana Immunization Network for Kids Statewide (LINKS), resulting in retrieval of 4,250 records as of Tuesday, September 27. Immunization registries querying LINKS are: Arizona, Houston, Idaho, Indiana, Maryland, Ohio, Washington, West Virginia, and Wyoming.
The importance of HL7 standards was never more evident than during Katrina, said Julie A. Boom, M.D., Medical Director, Houston-Harris County Immunization Registry and Director of the Immunization Project at Texas Children's Hospital, and AIRA member. Literally overnight, the Houston-Harris County Immunization Registry was able to be connected to the 'LINKS' Louisiana statewide immunization registry with the assistance of Scientific Technology Corporation. Because each registry was fully HL7 compliant, this link was able to be made quickly and easily. Retrieving these records from LINKS has saved the public health community thousands of dollars for the cost of re- immunizing these children and it saves the children of Louisiana from the discomfort of additional immunizations. This experience truly highlights the importance of following national standards and should encourage other immunization registries to fully support HL7 standards as soon as possible.
More solutions are in the works:
* Oracle Corporation, an HL7 benefactor, had been working in close
cooperation with the Louisiana Department of Health and Hospital to
create a regional solution for health information sharing before the
hurricane struck and is now accelerating those efforts.
* HL7 member organization OZ Systems, which provides information
technology for the State of Texas' Early Hearing Detection and
Intervention Program (TEHDI), is exploring ways to use HL7 messaging
standards to transfer hearing screening results data for Louisiana
newborn evacuees who had to have their screenings done in Texas. This
data needs to be sent back to respective birthing facilities in
Louisiana or the Louisiana Department of Health as needed for CDC
reports, or to assure that an infant receives care if necessary.
* Intel Corporation is coordinating the donation of 1,500 laptop personal
computers to the American Red Cross for distribution to shelters in
support of Katrina disaster relief efforts. In addition, Intel will
donate 150 wireless Internet access points.
* Additional support for the Gulf region has been pledged by HL7 members
including the Los Angeles County Department of Health Services,
Information Systems Branch; Medquist Corporation; Microsoft Corporation
and TeleVital.
HL7 and its more than 2,220 individual and corporate U.S. members have information technology expertise in all segments of the healthcare industry, and real-world experience in developing an infrastructure that is standards based and allows interoperable records to be distributed over multiple sites using multiple local applications. In addition, HL7's more than 500 corporate members include not only EHR vendors, but infrastructure and integration vendors together with suppliers of standards-compliant dictation and transcription.
HL7 Response and Recovery Taskforce
The HL7 Response and Recovery Taskforce has been meeting daily, speaking with government officials, technologists and planners. The Task Force will coordinate education and outreach to the HL7 community including vendors and providers, HL7 International Affiliates as well as other standards development organizations, and U.S. national bodies such as the Office of the National Coordinator for Health Information Technology (ONCHIT), the Department of Defense (DoD), the Veterans Health Administration (VHA), and the Centers for Disease Control and Prevention (CDC). The Taskforce will design, coordinate and organize implementation projects focusing on the creation of a healthcare information infrastructure to help address the personal and public health information crisis created by Katrina.
HL7 members wishing to be involved in this effort should respond via katrina@HL7.org and sign onto the Katrina support listserv available on the HL7 web site (www.HL7.org).
Participation by EHRVA
In the aftermath of Katrina, the EHRVA has been actively engaged with the Office of the National Coordinator for Health Information Technology (ONCHIT) and other healthcare stakeholders to support the potentially nomadic evacuee population in the goal of making medical record information available wherever they receive care.
* The EHRVA is on task of suggesting immediate means to meet emergency
patient information needs and laying the groundwork for rebuilding a
patient information management infrastructure. During this process, the
EHRVA is dedicating workgroup and executive committee time to plan a
practical framework.
* EHRVA contribution to Katrina Relief leverages the organization's
partnership with IHE and an ongoing commitment to devise viable
interoperability models.
* EHRVA is in dialogue with ONCHIT and channeling updates and requests to
members to support roll-out of response plans now and in the near
future.
EHRVA has joined with HL7 in this call to members to participate and pool resources for interoperable electronic health records. The two organizations are ideal partners in this effort, since two of their core goals are based on making progress in the areas of standards and interoperability. EHRVA is comprised of 35 member companies that serve the vast majority of healthcare providers in the nation with Healthcare Information Technology (HIT) solutions, which complements and overlaps with HL7's membership.
Since Hurricane Katrina we've been humbled by the dedication of our clients in hospitals and physician practices as they have brought EHR technology into the heart of the crisis. We are taking our cues from providers who are working from the conviction that a stronger HIT foundation will better prepare us for any eventuality such as these recent storms, said Charlene Underwood, EHRVA chairperson and Director, Government and Industry Relations for Siemens Medical Solutions.
Collaborative Efforts toward a Regional Recovery
The HL7 community has the largest single pool of expertise on healthcare information systems and how to connect them for effective collection and delivery of healthcare information. Its members are active in efforts with state and local and national agencies, including the Department of Health and Human Services and the Centers for Disease Control and Prevention. In addition to EHRVA, HL7 is offering to collaborate with all organizations providing solutions for the affected area.
About EHRVA
HIMSS EHRVA (http://www.himssehrva.org) is a trade association of Electronic Health Record (EHR) vendors who have joined together to lead the HIT industry in the accelerated adoption of electronic health records in hospital and ambulatory care settings in the US. The association provides a forum for the EHR vendor community to speak with a unified voice relative to standards development, the EHR certification process, interoperability, performance and quality measures, and other EHR issues as they become subject to increasing government, insurance and provider driven initiatives and requests. Membership is open to HIMSS corporate members with legally formed companies designing, developing and marketing their own commercially available EHRs with installations in the USA.
The association, comprised of 35 member companies, is a partner of the Healthcare Information and Management Systems Society (HIMSS) and operates as an organizational unit within HIMSS.
About HL7
Founded in 1987, Health Level Seven, Inc. (http://www.HL7.org/) is a not- for-profit, ANSI-accredited standards developing organization dedicated to providing a comprehensive framework and related standards for the exchange, integration, sharing, and retrieval of electronic health information that supports clinical practice and the management, delivery, and evaluation of health services. HL7's more than 2,000 members represent approximately 500 corporate members, including 90 percent of the largest information systems vendors serving healthcare.
HL7's endeavors are sponsored, in part, by the support of its benefactors: Accenture; Centers for Disease Control and Prevention (CDC); Duke Clinical Research Institute (DCRI); Eclipsys Corporation; Eli Lilly Company; the Food and Drug Administration; GE Healthcare Information Technologies; Guidant Corporation; IBM; IDX Systems Corporation; Intel Corporation, Digital Health; InterSystems Corporation; Kaiser Permanente; McKesson Provider Technologies; Microsoft Corporation; Misys Healthcare Systems; NHS Connecting for Health; NICTIZ National ICT Institute for Healthcare in The Netherlands; Oracle Corporation; Partners HealthCare System, Inc.; Pfizer, Inc.; Philips Medical Systems; Quest Diagnostics Inc.; Science Applications International Corporation; Siemens Medical Solutions Health Services; Solucient, LLC; the U.S. Department of Defense; Military Health System; the U.S. Department of Veterans Affairs; and Wyeth Pharmaceuticals.
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